Employment application

Note: Information to be supplied on this application complies with the relevant Privacy legislation regarding employment details. The information contained herein is strictly private, and not disseminated to third parties except under due process of law.

Employer

Applicant name
Position
Position no.

EMPLOYMENT TYPE

Permanent

Temporary

POSITION INFORMATION

(Tick all applicable categories)

Full time

Part time

Casual

Shifts (if applicable)

Morning

Afternoon

Night

APPLICANT INFORMATION

Full name: First name Middle name(s) Surname

Residential address

Apartment/street number

Street

Suburb

City (if part of normal postal address)

State/province

Country

Post code or Zip code

Phone number (include area code)Mobile
Fax

Email

Date of birth 00/00/00

Applicant disability information

Are you officially classified as having a disability? Yes / No
If yes, describe the disability as per your classification

If you served in the military, please provide the following information:

Armed Forces branch Army / Navy / Air Force / Marines / Coast Guard

Dates of service 00/00/00 to 00/00/00

Rank on departure

Specialist status (insert full description)

Honorably discharged Yes / No

EMPLOYMENT HISTORY

List your two most recent employers only.

Name of current or previous employer
Contact details
Name of position held

Period of employment 00/00/00 to 00/00/00Reason for leaving

Name of former employer
Contact details
Name of position held

Period of employment 00/00/00 to 00/00/00Reason for leaving

OTHER QUALIFICATIONS

List any relevant qualifications, experience or skills which you consider relevant to this position, including hobbies.

EMPLOYMENT REFERENCES

Please supply names and contact details of two referees

Name of referee
Relationship to employment

Name of referee
Relationship to employment

EMERGENCY CONTACT PERSON:

Name
Contact details

Note: Under employment law, information given on this application must be correct and factual. Any information provided which is false or misleading may lead to refusal of the application, and / or disqualification from consideration of any future applications. Penalties may apply in some cases.

Signature of applicant
Date

Disclaimer

Please note:

This text is intended for advisory and guideline purposes only.

Any business letter can become a legal document, so check your content properly before issuing.

Any executable or statutorily defined document should be checked for compliance with legal requirements, and you should seek legal advice regarding its contents.